“The civilizing influences that surround these people are far from good. The class of people that are frequently found as neighbors are a shiftless, undesirable class. These Whites live amidst unsanitary, meagre surroundings. It is due to this class of citizens that the use of cocaine has of recent years assumed alarming proportions. This habit has become quite common among the full-bloods in some sections, and I heard of several deaths that were attributed directly to this cause. “The use of alcoholic liquor is, no doubt, a positive detriment to the Choctaw Indians, particularly in those districts close to the Arkansas border. Many crimes have been committed among the Indians that can be attributed directly to the use of liquor, given to them by unscrupulous bootleggers from across the border. “Trachoma appears to be even more universal among the Creeks and Seminoles than it is among the Indians farther south, and many cases are observed. Trachoma is, no doubt, a positive menace to the usefulness and well-being of many of these people, and should be met by a vigorous campaign for its control. [Illustration: INDIAN CABIN, NORTH DAKOTA Six of the seven inmates had trachoma. ] “The native medicine man appears to play a more important part among the Creeks and Seminoles than among the other Indians of the Five Civilized Tribes. The full-blood Indians seldom call on the local white physician for treatment, but depend almost entirely upon their own medicine men, and the use of patent remedies, purchased at the local country stores. Several bottles of a patent consumption “cure” were seen in a number of homes visited. “After a careful survey of the conditions existing among the full-blood Indians of the Five Civilized Tribes, it seems highly important that there should be a well-organized system of medical treatment provided. Tuberculosis and trachoma, the two most important diseases to be combatted among Indians generally prevail among these people to an alarming extent, and both appear to be steadily on the increase. It is unquestionably true that many of these Indians sicken and die without any medical aid whatever. Many of them are too poor to employ white physicians, with the result that the physician is either not called at all, or only when it is too late to be of any avail. “Too much emphasis cannot be placed upon the need for hospital facilities for these Indians. There is, at present, no place available in which to place the needy sick except in local city hospitals. This necessarily entails considerable expense on the individual and, in many instances, there is a prejudice against going away from their homes to enter a strange hospital. The several sanitariums throughout the Service are usually already filled beyond their capacity, and it is seldom possible to secure their admission to the institutions.